A research teaching and clinical program will be undertaken by the applicant, Gabriel H. Brandeis, MD, in the Division on Aging at Harvard Medical School. The Award will provide five years of supervised experience so Dr. Brandeis can develop his potential to become a leader in academic geriatrics. Dr. Neil Resnick, a former Academic Award recipient and Chief of Geriatrics at Brigham and Women's Hospital, will serve as the sponsor. The research component will be an investigation of a common, morbid and long-neglected problem -- established urinary incontinence in elderly institutionalized women. The project's goal is to design a simple clinical strategy to distinguish women who might benefit from urologic referral from those who would not; this would permit the majority to be safely and effectively treated by a geriatrician or primary care physician without invasive testing. In addition to the formal meetings scheduled with Dr. Resnick, Dr. Brandeis will work with him on a daily basis in design, development, and analysis of the planned investigation. Furthermore, Dr. Subbarao Yalla (Associate Professor of Urology) will assist with the project, and closely supervise the development of Dr. Brandeis' urodynamic skills. The educational component will build upon Dr. Brandeis' skills as a teacher and his current work with medical students. He will use this base to design and implement teaching modules in undergraduate medical education for use in Harvard Medical School's New pathway curriculum. Dr. Resnick and Luann Wilkerson, EdD, (Director of the Office for Educational Development) will guide Dr. Brandeis as he writes and implements the curriculum. They will provide direct feedback by continually monitoring his teaching techniques. Clinical activities will continue throughout this Award through attending on the Beth Israel Hospital and Brigham and Women's Hospital Consultation Services, and the Continence Center at Brigham and Women's Hospital. The applicant will supervise students, residents, and fellows, and collaborate with gerontologic nurses and social workers, thus further developing his clinical geriatric expertise and teaching skills. The amount of effort on each component will remain constant for the duration of the Award. The very substantial research, educational, and clinical resources of Harvard's Division on Aging will be available to the applicant to assure successful attainment of the goals of this Award.